Sepsis is characterized by a dysregulation of immune response to infection, leading to life-threatening organ dysfunction. Sepsis-associated liver injury (SALI) is considered an independent risk factor for predicting death in the intensive care unit (ICU). With the increasing number of studies on the gut-liver axis in recent years, the close linkage of gut microbiota and liver diseases has been gradually revealed. Dysbiosis of gut microbiota has been shown to induce SALI through the mitogen-activated protein kinase/nuclear transcription factorκB (MAPK/NF-κB) signaling pathway and damage to the intestinal barrier. Meanwhile, fecal microbiota transplantation (FMT) and the application of probiotics have great potential in the treatment of SALI. This paper reviews the relevant research progress in recent years both at home and abroad, in order to provide new insights into the pathogenesis and treatment of SALI.
Craniopharyngioma-related hypothalamic obesity (CHO) has become a key issue in postoperative management of craniopharyngioma. Modified low calorie diet and exercise interventions have been found by some studies to be effective in relieving CHO, and suggested to be used as non-pharmacological treatments for weight management of craniopharyngioma patients. However, there are few relevant studies in China. We reviewed the latest developments in prevalence, hazards and risk factors as well as diet and exercise interventions towards CHO, in order to improve the outcomes and quality of life of CHO patients. In addition, we put forward recommendations on comprehensively improving the quality of life of CHO patients, such as making efforts to value CHO clinically, carrying out prospective studies on weight control in CHO, and developing rigorous diet and exercise interventions.
A large number of studies have confirmed that endoplasmic reticulum stress (ERS) is closely related to the development and progression of liver diseases, but the mechanism of the association between ERS and liver disease progression has not been clarified and needs to be further explored. Numerous studies have found that moderate ERS can activate the unfolded protein response (UPR) to protect cells, while severe or persistent ERS can induce apoptosis. Therefore, exploring the role of ERS in the pathogenesis of liver diseases may help to discover new therapeutic strategies. This paper describes the current research status and potential therapeutic strategies of ERS and UPR in various liver diseases.
As a common anorectal disease, the high incidence and recurrence of hemorrhoidal disease impose pressure on both doctors and patients. Hemorrhoidal disease assessment is a necessary prerequisite for diagnosis and selection of appropriate treatment options. Objective assessment of hemorrhoidal disease and selection of an appropriate treatment are strong concerns of clinicians, and many hemorrhoidal disease classification methods have been developed recently. We reviewed these recently emerged hemorrhoidal disease classification methods, which mainly include prolapse-dominated classification methodologies (Goligher classification, Indian new classification algorithm of haemorrmoids, single pile classification, algorithm for grading prolapsing haemorrhoids), bleeding-dominated classification methodologies (Japanese endoscopic classification of internal hemorrhoids, PNR-bleeding classification), and comprehensive classification methodologies[Lunniss's classification of internal haemorrhoids, anatomical/clinical-therapeutic classification, BPRST classification, BPECT classification, four-factors (PBCE) hemorrhoids classification], then analyzed evaluation values, essential factors, principles of use and components of assessment indicators of the methods. Afterwards, we put forward optimization strategies targeting their limitations and predicted their possible future development directions. All these will provide a reference for the development regarding the assessment and classification of hemorrhoids and clinical diagnosis and management of hemorrhoids.
Post-stroke cognitive impairment, characterized by cognitive dysfunction, is a common complication of stroke and has a direct impact on the quality of life of ischemic stroke patients. Previous studies have found that astrocytes play an important role in the pathogenesis of PSCI. In addition, extracellular vesicles (EVs) have been recognized as an important medium for intercellular communication and are involved in various pathophysiological processes by carrying and transporting various cargoes. Astrocyte-derived extracellular vesicles (ADEVs) may communicate with other brain cells to improve PSCI by enhancing synaptic plasticity, modulating neuroinflammation, regulating angiogenesis and autophagy. This review clarifies the multiple effects of ADEVs on the development of PSCI, offers new strategies for studying the underlying mechanisms of PSCI, and further explores the potential uses of ADEVs as novel drugs and biomarkers in the diagnosis and treatment of PSCI.
Gastric cancer (GC) is one of the most heterogeneous and aggressive malignant tumors of the digestive system. Traditional chemotherapy drugs and epidermal growth factor receptor 2 (HER2) targeted drugs such as Trastuzumab still have the disadvantages of high incidence of drug resistance, high toxic side effects and poor tolerance of patients. Therefore, it is imperative to develop more effective anti GC drugs. Novel targeted drugs against HER2 are currently available, but are ineffective or resistance in some cases, which is related to the low expression of HER2 (HER2 IHC1+ or IHC2+/ISH-) in certain GC cells, accounting for about 40%-60% of all types. However, in clinical practice, these patients are still reported as HER2-negative GC. Therefore, accurate detection of HER2 expression is crucial to identify patients who may benefit from trastuzumab therapy. The emergence of antibody drug conjugates (ADC) provides a new therapeutic option for HER2-positive GC and it is expected to replace traditional GC chemotherapy in the future by its precise and efficient anti-tumor effect. Recent studies have found that ADC may have potential anti-tumor activity in HER2 low-expression GC, and related clinical studies are evaluating its effectiveness and safety in HER2 low-expression GC treatment. This article reviews the application and the latest research progress of ADC in HER2 low-expression GC patients in the era of targeted therapy and discusses the challenges faced in the application and development of HER2-targeted ADCs.
Previous studies on renin-angiotensin-aldosterone system (RAAS) mainly focus on renin, prorenin and prorenin receptor (PRR), which play an important role in cardiovascular, renal and other diseases. The physiological function of PRR has been widely studied. Soluble prorenin receptor (sPRR) is generated by cleavage of extracellular components of PRR by protease and secreted into extracellular space, therefore the change of sPRR level may reflect the change of RAAS in tissue. However, there are limited clinical researchs on sPRR. In recent years, increasing evidences show that sPRR has important biological functions in various pathophysiological processes. This article summarized the recent advances in sPRR in cardiovascular system, kidney diseases, respiratory diseases, endocrine and metabolic diseases, pregnancy complications and cancers, and considered that sPRR may be a new biomarker of multiple diseases, and has potential therapeutic effects on metabolic diseases.
Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide, its close correlation with metabolic disorders has been demonstrated in numerous studies in recent years and an expert panel has proposed renaming it metabolic-associated fatty liver disease (MAFLD). NAFLD/MAFLD may not only increase the incidence and mortality of liver-related diseases but also relate to the incidence and mortality of cardiovascular diseases. This article compares the diagnostic criteria of NAFLD/MAFLD and reviews the research progress in the correlation of non-alcoholic fatty liver disease and metabolic-associated fatty liver disease with cardiovascular diseases. The results show that both NAFLD/MAFLD are significantly associated with the increased incidence of cardiovascular diseases and independent risk factors for cardiovascular diseases. Furthermore, MAFLD patients have a higher risk of developing cardiovascular diseases than NAFLD patients. This article provides clinical physicians with the basis for cardiovascular risk assessment and management in NAFLD/MAFLD patients, emphasizing that in addition to the treatment of liver disease, clinical physicians should also focus on the risk of cardiovascular disease in NAFLD/MAFLD patients.
Surge hospitals play an important role in combating a major infectious disease outbreak. Compared with other situations, the management and operation of surge hospitals amid the outbreak of major infectious diseases are specific, and serious consequences will be caused if there is a loophole in the hospital management model. However, there is no research that reviews and summarizes relevant studies.
To perform a scoping review of the research on surge hospital management during a major infectious disease outbreak, so as to understand the elements of hospital management and research status, providing guidance for future research in this field.
This review used a methodological framework developed based on Arksey & O'Malley's framework and principles as well as recommendations from related scholars and colleagues' guiding principles. Studies on the management of surge hospitals amid the outbreak of major infectious diseases were searched in electronic databases of PubMed, Embase, Cochrane Library and SinoMed from inception to June 17, 2022. Then the included studies were summarized and analyzed.
Twenty-five studies were included. All studies were about the management of mobile cabin hospitals and designated hospitals for treating COVID-19 in China during the COVID-19 pandemic. The elements of surge hospital management included emergency preparedness, personnel management, operation management and service management.
The number of studies on surge hospital management has increased, with an extensive scope of research, but the quality of them is unsatisfactory, and there is a lack of unified evaluation indicators and feedback tools. In the future, efforts should be made to improve the quality of relevant studies, formulate a standardized surge hospital management process, increase the construction and implementation of evaluation indicators, so as to provide more guidance for clinical nursing practice.
A body shape index (ABSI) is a novel anthropometric index derived by specific algorithms based on measurements of height, weight, and waist circumference. Central obesity has become more important for predicting the occurrence and mortality of cardiovascular events with the increasing number of overweight and obese people. Obesity contributes to the development of cardiovascular diseases such as atherosclerosis, hypertension, coronary heart disease and even death by stimulating the production of inflammatory factors that induce chronic inflammatory responses, insulin resistance, metabolic disorders and oxidative stress pathways. ABSI is strongly related to abdominal obesity and can predict atherosclerosis in some populations, but it is also affected by population characteristics, such as the difference in the correlation between ABSI and atherosclerosis in populations of different regions, genders and ages. It is of great significance for early identification of high-risk populations and rational prevention and treatment of cardiovascular diseases to clarify the relationship between ABSI and atherosclerosis.
Chronic kidney disease-mineral and bone disorder (CKD-MBD) has a direct impact on patients' quality of life, hospitalization rates and fracture risk. In recent years, osteoblasts and osteoclasts have become central to the pathophysiology of CKD-MBD. Osteoblasts interact with other organs by synthesizing fibroblast growth factor-23 (FGF-23) and sclerostin (SOST), making the skeleton an endocrine organ. Therefore, dysregulation of osteoblast differentiation is an important early event in the pathogenesis of CKD. In this paper, we systematically discuss the metabolic pathways of osteoblasts and the mechanisms related to the altered metabolic reprogramming of osteoblasts in the early CKD-MBD pathology. This paper shows that abnormalities in signaling pathways and metabolites such as Wnt/β-catenin, FGF-23, uremic toxins, metabolic acidosis, can alter the metabolic activity of osteoblasts, causing impaired maturation of the osteogenic spectrum, which in turn affects bone remodeling, which will provide a new way of thinking for explaining the pathological changes in renal bone disease and developing clinical treatment options.
24-hour movement behaviors include physical activity, sedentary behavior and sleep. Domestic and foreign studies have found that the elderly generally have problems of low physical activity, sedentary behavior and insufficient sleep. Rational allocation of 24-hour movement behaviors has been demonstrated to be an important measure to improve adverse health outcomes in older adults, but the relevant research on 24-hour movement behaviors of the elderly is still in the exploratory stage. This paper reviews the concept, theoretical development and analytical methods of 24-hour movement behaviors and its relationship with adverse health outcomes in the elderly. In the future, relevant studies should be actively carried out to deeply explore and quantify the impact of 24-hour movement behaviors on health, develop a combination of 24-hour movement behaviors that can exert the maximum health benefits of the elderly, and develop accurate assessment tools, so as to promote active and healthy aging.
Traumatic central nervous system injury can cause imbalance in intestinal microenvironmental homeostasis by disrupting intestinal barrier function, while the disturbed intestinal microenvironment can react on the central nervous system and aggravate the secondary injury of it. A large number of studies suggest that the intestinal barrier plays an important role in the pathophysiological process of traumatic central nervous system injury and can be an important target for the action of central nervous system injury. This paper reviews the structural and functional changes of intestinal microbial, chemical, mechanical and immune barriers after traumatic central nervous system injury and their bidirectional interaction with the central nervous system, summarizes the possible mechanisms leading to the disruption of intestinal barrier, including malnutrition, ischemia-reperfusion injury, inflammatory response and the release of neurotransmitters and hormones, to provide theoretical basis and new ideas for the development of research on the intestinal microenvironment after traumatic central nervous injury.
Ferroptosis plays an important role in the progression of non-alcoholic fatty liver disease (NAFLD) as a novel mode of programmed cell death. Heme oxygenase-1 (HO-1), acting as an inducible oxidase, has been shown the capability of alleviating oxidative stress and hepatocyte necrosis to prevent or delay the progression of NAFLD. However, the mechanism of HO-1 regulating ferroptosis and affecting the development of NAFLD remains inadequately explored. This review provided a systematic and comprehensive summary of the effects of HO-1 on NAFLD by regulating ferroptosis, and discussed the mechanism of HO-1 in preventing the development of NAFLD by summarizing the relevant literature in recent years, and showed that HO-1 regulates ferroptosis in NAFLD through the generation of antioxidants (such as bilirubin and CO), activation of the System Xc, and facilitation of ferrous ion accumulation, in order to provide a theoretical basis for targeting HO-1 gene therapy for NAFLD by methods such as pharmacological interventions and provide a reference for further research.
As a common affective mental disorder, depressive disorder has currently become the second health burden worldwide, however, its pathogenesis remains to be further elucidated. The clinical treatment of depressive disorder primarily relies on western medicine. However, there is great clinical need for effective and rapid-onset antidepressants for the unsatisfactory effect, obvious treatment time-lag, and intolerable adverse reactions of current drug treatment. Ferroptosis is a novel form of cell death discovered in recent years, which has been found to be involved in the pathogenesis of numerous neurological disorders, including depressive disorder. Currently, some studies have shifted the focus of antidepressant treatment towards targeted inhibition of ferroptosis, and achieved positive outcomes. The present paper provides a comprehensive review of the involvement of ferroptosis in depressive disorder pathogenesis and its potential therapeutic implications, drawing on clinical and preclinical evidence that elucidates the underlying mechanisms linking depressive disorder with ferroptotic processes.
Dyslipidemia may be related to the occurrence and development of colorectal tumors. Numerous studies have confirmed that dyslipidemia increases the risk of colorectal adenomas at present; however, the association of dyslipidemia with colorectal serrated lesions and colorectal cancer is still controversial, and there are few relevant reviews in China. This article comprehensively explores the correlation of dyslipidemia with colorectal serrated lesions and colorectal cancer, analyzes the possible causes of controversy, identifies the directions of subsequent researches, and discusses the role of dyslipidemia in the occurrence and progression of colorectal tumors. This article indicates that dyslipidemia is associated with colorectal serrated lesions and colorectal cancer. Dyslipidemia may be involved in the development of colorectal tumors through the interaction of multiple mechanisms such as insulin resistance, inflammatory factors, oxidative stress, high-fat diet and immunosuppression. The incidence of colorectal cancer is increasing yearly with a relatively slower natural course and more definite precancerous lesions. Therefore, the clarification of correlation between lipid indexes and colorectal tumors can facilitate early prevention and targeted screening of colorectal tumors and provide a reference for formulating targeted prevention strategies for colorectal cancer.
Traumatic central nervous system injury, including traumatic brain injury and spinal cord injury, has extremely high disability and mortality rates. The huge medical expenses and sequelae further aggravate the economic and psychological burden of patients and their families. Current treatments for traumatic central nervous system injury include surgical therapy, physical therapy, medication and post-rehabilitation treatment, but none of them can achieve ideal efficacy, and more effective treatment is urgently needed. Ferroptosis, as one of the newly discovered modes of programmed cell death, has been shown to play a crucial role in secondary injury to the traumatic central nervous system, but its clinical transformation is limited. This article summarizes the research results of ferroptosis inhibitors, points out the types and effects of them, to provide new ideas for clinical treatment of traumatic central nervous system injury and drug development.
Isocitrate dehydrogenase (IDH) is the more mutation-prone human metabolic gene. In the presence of nicotinamide adenine dinucleotide phosphate (NADPH), mutant IDH can bind to α-ketoglutaric acid (α-KG) and reduce it to 2-hydroxyglutaric acid (2-HG), participating in various biological processes of tumorigenesis. IDH has been widely studied in glioma and acute myeloid leukemia, and rarely in chondrosarcoma. Chondrosarcoma is prone to recurrence and metastasis due to the presence of high-frequency mutations in the IDH gene, and treatment options are limited after recurrence or metastasis, resulting in a poor prognosis for patients and an urgent clinical need to find new treatment options. This article reviews the role of IDH mutations in the development, prognosis, differential diagnosis and treatment of chondrosarcoma, further elaborates the biological role of IDH gene mutation in the occurrence and development of chondrosarcoma, and provides an outlook on the development of powerful IDH inhibitors and anti-cancer drugs, in order to provide a reference for the establishment of therapeutic regimen and prognostic evaluation.
According to the latest statistics released by the World Health Organization, cardiovascular disease ranks as the leading cause of death worldwide. The number of deaths caused by cardiovascular disease exceeds that of any other diseases, that needs to be tackled by global public health. At the same time, according to statistics released by the World Health Organization in 2022, the prevalence of mental illness in China is as high as 17%. In the past 20 years, the incidence of depression in the Chinese population has increased 120 times. The correlation between cardiovascular disease and mental illness has been found to be significant with an underlying mechanism. This article aims to elucidate advances in the correlation between cardiovascular disease and mental illness, as well as their underlying mechanisms, showing that anxiety and depression are important drivers of cardiovascular disease by causing damage to the heart through the autonomic nervous system and the hypothalamic-pituitary-adrenal axis, while ischemic cardiomyopathy and myocardial infarction can induce adverse mood and cognitive impairment by mediating ischemic damage and inflammatory responses in the brain. This article can provide additional preventive ideas for patients at high risk of cardiovascular disease, as well as for the diagnosis and treatment of patients with mental illness, and provide a reference for the psycho-cardiology interdiscipline.
Stroke has become the leading cause of death in China, and rational diet is an important primary prevention strategy, but the optimal dietary pattern remains to be studied. Based on this, this paper reviews the progress of epidemiological studies on the correlation of Mediterranean Diet (MD) , Dietary Approaches to Stop Hypertension (DASH) pattern, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, Japanese dietary pattern and Chinese diet pattern with cerebrovascular diseases, and suggests that MD pattern, DASH pattern and Japanese dietary pattern have protective effects on cerebrovascular disease; however, the relationship between MIND pattern and cerebrovascular disease remains uncertain. There is a lack of large-scale randomized controlled trials to examine the effect of traditional Chinese dietary pattern on cerebrovascular diseases. In the future, active efforts in exploring the healthy dietary patterns in line with local dietary habits are needed for providing a Chinese strategy for primary stroke prevention.
Primary liver cancer is one of the common cancers in the world and with extremely high morbidity and mortality. This paper details the current epidemiology of primary liver cancer, population attributable fractions and associated risk factors in China. In this paper, we found that hepatitis B virus and hepatitis C virus are still the main risk factors for the development of primary liver cancer by searching the databases such as PubMed, Web of Science, and CNKI. With hepatitis B virus vaccination and antiviral treatment, the incidence of primary liver cancer in China has slightly decreased, but the incidence of primary liver cancer caused by metabolic factors such as diabetes, obesity and non-alcoholic fatty liver disease is gradually increasing; smoking and alcohol consumption are also important risk factors. This article summarizes the epidemiological characteristics and risk factors of primary liver cancer, which can provide practical evidence-based medicine evidence for the development of preventive and control measures for primary liver cancer.
There are many types of assessment tools for dementia patients both domestically and internationally. However, assessments using single-dimensional measurement tools often have limitations, and there is still a lack of reports on comprehensive assessment tools specifically for dementia patients in current. Based on this, the comprehensive assessment tools for the elderly with dementia are reviewed both domestically and internationally, 8 assessment tools from the perspectives of demand and function for the elderly with dementia are summarized, and the content, reliability and validity, application of each tool are discussed in this paper, in order to provide reference for the use and development of assessment tools for the elderly with dementia in China.
Mental illness usually involves a range of cognitive, behavioral, and affective symptoms associated with impaired occupational or social functioning. Duration of untreated psychosis (DUP) is considered as an important predictor and independent risk factor for the prognosis of patients with mental disorders, a longer DUP is associated with poor prognosis. Meanwhile, early intervention measures to shorten DUP have gradually attracted increasing attention from both domestic and international researchers. In this paper, the related studies on DUP were reviewed and analyzed, the concept, measurement tools, neurobiological mechanisms of DUP, the relationship between DUP and prognosis, and early intervention measures to shorten DUP were described, in order to provide ideas and reference for developing clinical intervention strategies for DUP.
Spinal degenerative diseases are currently most common clinical conditions and also dominant diseases in the field of traumatology and orthopedics. Traditional Chinese manipulative therapy is a common approach for spinal degenerative diseases in traumatology and orthopedics of Chinese medicine. However, the current researches on the efficacy mechanism of traditional Chinese manipulative therapy is still not deep enough, which hinders the modernization and internationalization of the study on the manipulative therapy. Combination of medicine and industry is a novel research idea generated by the combination of relevant scientific and technological progress and the modernization of traditional Chinese medicine in recent years, which is helpful to realize the modernization of the research on the efficacy mechanism of traditional Chinese manipulative therapy and promote the internationalization of traditional Chinese manipulative therapy. Using the application status of modern engineering technologies such as mechanical engineering technology, software engineering technology, neural engineering technology and artificial intelligence technology in the research of traditional Chinese manipulative therapy as research ideas, this paper sorts out the researches on the modernization on the efficacy mechanism of traditional Chinese manipulation under the "combination of medicine and industry" research model in recent years, in order to provide reference ideas for the subsequent researches of the efficacy mechanism of manipulation in the treatment of spinal degenerative diseases.
Limb paralysis is a common sequela of cerebral infarction, which leads to both physical disorders and heavy psychological burden. Recent years have witnessed growing studies on the prognosis of motor function in patients with cerebral infarction, and increasing well-known relevant medical evaluation tools, such as diffusion tensor imaging (DTI) and motor evoked potential induced by transcranial magnetic stimulation (TMS-MEP), which can microscopically assess the structural changes in white matter fiber bundles, and the combined use of them, that is, the combination of neuroanatomy, electrophysiology and neuroimaging, can more accurately assess the level of motor neuron impairment, thereby obtaining a motor function assessment surpassing the assessment based on clinical function indicators in terms of objectivity. We reviewed the prognostic value of DTI and TMS for motor function recovery via detecting and quantifying corticospinal tract degeneration in patients after cerebral infarction, and summarized the prognostic values of commonly used relevant measurement parameters for motor function recovery in hemiplegic patients. We concluded that DTI and TMS-MEP are powerful tools for noninvasively assessing complex structures of brain tissues, which can detect more subtle neural and tissue changes, and the combined use of them can effectively explore the damage pattern of white matter fiber bundles using different analysis methods, contributing to the development of neurological rehabilitation programs and maximum improvement of the long-term prognosis for patients.
Stroke often leads to persistent post-stroke cognitive impairment (PSCI), which mainly manifests as impairment in learning and memory. The pathogenesis remains unclear as present, but it is closely related to mitochondrial dysfunction, and healthy mitochondria are essential for neuronal survival. Recent studies have shown that intercellular mitochondrial transfer can be linked to stroke through increasing neuronal viability, enhancing mitochondrial metabolism, and modulating neuroinflammation, thereby improving cognitive impairment. This review overviews the mechanisms of mitochondrial transfer and the key role of intercellular mitochondrial transfer in PSCI, and discusses that mitochondrial transplantation may serve as a novel therapeutic intervention for PSCI, providing references for its clinical management.
The liver is the largest metabolic organ in the human body, and impaired liver function can lead to a variety of acute and chronic liver diseases, which can affect the quality of life in mild cases or be life-threatening in severe cases. Therefore, it is important to explore accurate and effective molecular diagnostic markers and therapeutic targets. Mitofusin 2 (Mfn2) is a transmembrane motor protein on the outer membrane of mitochondria, and plays an important role not only in mitochondrial fusion regulation, but also in cell energy metabolism, cell apoptosis, cell proliferation, mitochondrial endoplasmic reticulum (ER) connections, ER stress and mitochondrial autophagy, etc. It has been found that abnormal expression or function loss of Mfn2 can lead to abnormal mitochondrial function, which in turn leads to a variety of liver diseases. In this paper, a systematic review of the structure and function of Mfn2 and its mechanisms of action in liver diseases was conducted and found that Mfn2 can be involved in the development of chronic liver diseases through multiple pathways, and improve liver function through modulating Mfn2 overexpression to further slow down and reverse disease progression. This paper aims to provide a scientific reference for basic research of Mfn2 and liver diseases, as well as its clinical application.
Inflammatory bowel disease (IBD) is a group of chronic non-specific gastrointestinal inflammatory conditions, whose pathogenic factors and pathogenesis may be related to environmental factors, genetic susceptibility, gut microbiota and immune responses. Ferroptosis is a newly found cell death caused by the accumulation of iron-dependent lipid hydroperoxides, which is tightly regulated by a lipid repair system including glutathione (GSH) and glutathione peroxidase 4 (GPx4). Increasing studies have reported the fundamental features of ferroptosis in the injured gastrointestinal tract in IBD patients, including iron deposition, GSH exhaustion, GPx4 inactivation, and lipid peroxidation. Furthermore, regulating the key ferroptosis-related genes may alter the progression, severity, or even morbidity of IBD. We reviewed the basic mechanism of ferroptosis, and the prospect of ferroptosis pathways as therapeutic targets in IBD. In addition, the initiation of ferroptosis for improving IBD by extrinsic (transporter-dependent) or intrinsic (enzyme-regulated) pathway, may be a new direction for clinical treatment of IBD.
Excessive salt intake is a major risk for hypertension, an illness posing a serious threat to human health. Salt-sensitive blood pressure (SSBP) refers to a rising blood pressure response to relatively high salt intake, which is a susceptibility of blood pressure to salt in some individuals. Recent studies have found that gut microbiota is significantly associated with blood pressure and salt intake, and it plays an important role in the development of SSBP. We reviewed the advances in the association of dietary salt intake, gut microbiota and SSBP, and summarized that gut microbiota plays an important role in high-salt diet-induced intestinal inflammation and hypertension, indicating that gut microbiota and its disturbance as well as inflammation/immune responses may be possibly involved in the development of SSBP. This review will provide new ideas for clinical prevention and treatment of SSBP by adjusting the homeostasis of gut microbiota and related inflammatory and immune pathways.
Rheumatoid arthritis (RA) is a refractory autoimmune disease with chronic and systemic characteristics, however, the pathogenesis of this disease has not been fully defined. Autophagy is a metabolic process that exists in eukaryotic cells and maintains normal physiological activities and cell homeostasis. Dysregulation of autophagy is related to the occurrence and development of various diseases such as RA. The databases of CNKI, Wanfang Data, VIP, PubMed, Web of Science, Elsevier, etc. were searched for the literature related to autophagy in RA pathogenesis. The role of autophagy in the pathogenesis of RA was summarized in terms of maintaining synovial inflammation (improving anti-apoptosis rate of synovial cells and regulating the phenotype transformation of synovial cells), promoting bone destruction (participating in osteoclastogenesis and regulating chondrocyte apoptosis) and disrupting immune system homeostasis (regulating the activation and maturation of immune cells, participating in the presentation of citrullinated proteins, and inducing carbamoylation of proteins), in order to provide basis and reference for the pathogenesis research and treatment of RA.
As the second most serious disease worldwide, the etiology and pathogenesis of depression have not been clearly defined. Depression treatment faces a bottleneck, due to limitations of common therapies, such as side effects associated with drug therapy and high risk of recurrence after drug therapy, high requirements for clinicians to perform psychotherapy, and high cost of modalities and disorientation in physical therapy. Transcranial low-level laser, a new therapy has recently proven to be effective in scientific research and clinical antidepressant treatment, utilizes low-level laser non-invasively passing through the skull without causing damage to regulate biological tissues and protect neurons. Even though the molecular and cellular mechanisms underlying the therapy for depression are not yet clear, this non-drug therapy could be highly promising for depression treatment.
Inflammatory bowel disease (IBD) is a chronic non-specific intestinal inflammatory disease featured by repetitive episodes of gastrointestinal inflammation, including ulcerative colitis and Crohn's disease. The etiology and pathogenesis of IBD have not been fully identified, and there is still no cure currently. Nevertheless, new treatments have been developed recently, such as biological agents and small-molecule drugs, stem cell transplantation, fecal bacteria transplantation, and monocyte adsorption apheresis, along with the roles of TNF-α, interleukin, integrin receptors, JAK/STAT pathway and intestinal flora in the pathophysiology of IBD gradually revealed by increasingly deepening research on IBD. Although many new treatments are still being researched, they have been proven effective and safe, which might make up for the shortcomings of previous therapies, and may be alternative choices for individualized treatment of IBD in the future. This article reviews the recent developments in novel treatments for IBD.
Neurodegenerative diseases are a group of conditions caused by the progressive loss of the function or structure of neurons in the central nervous system. Although the physical or mental symptoms of neurodegenerative diseases can be alleviated by combined therapy, there is no strategy to directly slow down or prevent neurodegenerative diseases. Recent studies on the microbiota-gut-brain axis have found that gut microbiota and their metabolites play an important role in the occurrence and development of nervous system diseases. As the main metabolites of gut microbiota, short-chain fatty acids (SCFAs) , are the key transmitter involved in gut-brain communication and have neuroprotective effect on neurodegenerative diseases, but the specific mechanism is not clear. This article mainly reviews the mechanism of SCFAs in neurodegenerative diseases. It is concluded that improving the level of SCFAs in vivo by changing dietary habits via increasing dietary fiber intake and supplementing probiotics and exogenous SCFAs, may become a new safe and effective target for the prevention and treatment of neurodegenerative diseases, which may provide guidance for the treatment of neurodegenerative diseases.
Foreign studies suggest that interactive reading is an exploratory intervention for improving the oral language skill of children with autism in their early years. We summarized and analyzed empirical studies on the effects of interactive reading interventions on oral communication skills of preschool children with autism. The results indicate that the interventions have positive impacts on vocabulary development and spontaneous responses in preschool children with autism, but have discrepant effects on their spontaneous initiations. However, due to the small sample size of these studies, the effects of interactive reading interventions on oral communication in preschoolers with autism need to be further studied. It is expected that future research will explore and verify the effects of interactive reading interventions on both spontaneous responses and initiations in large samples of autism preschoolers, and further investigate whether these effects can be maintained and generalized.
Antibiotics are one greatest medical discoveries in the 20th century, which are extensively used to treat a variety of pathogenic microbial infections, including irritable bowel syndrome (IBS) . Although antibiotics have proven to be partially effective in improving clinical symptoms of IBS by clinical practice and several clinical studies, and nonabsorbable rifaximin has been also recommended for treating IBS without diarrhea by relevant guidelines and consensuses, the indications for the use of antibiotics in IBS are not clear, and there are concerns about the adverse effects associated with long-term antibiotic use. Meanwhile, making the balance between adverse effects and clinical benefits is difficult. However, several studies have also found that antibiotic use contributes to the development of IBS. This paper reviews recent studies on the effects of antibiotics on IBS, and summarizes that antibiotics may trigger IBS in several ways, including reducing intestinal microbial diversity, impairing epithelial barrier function and affecting cytokine production. This paper also points out the uncertainty of the indications for antibiotic application in IBS from two aspects, and argues that clinicians should pay attention to the effects of antibiotics on the development of IBS, evaluate the pros and cons of antibiotic treatment for IBS, and use antibiotics rationally and cautiously. The purpose of this article is to provide some reference for explaining the pathogenesis of IBS induced by antibiotic treatment, and for clinical application of antibiotics in IBS.
Visceral hypersensitivity is one major pathophysiological characteristic of irritable bowel syndrome (IBS) , a common functional bowel disorder. The detection and evaluation of visceral hypersensitivity are of practical significance for the guidance of clinical diagnosis and treatment of IBS. We reviewed the latest studies on the detection and evaluation methods of visceral hypersensitivity mediated by both peripheral and central factors in IBS patients and animal models, and found some limitations in these studies such as monotonous evaluation methods, and limited applications of the methods. The possible applications of these methods in both animal experiments and clinical trials can be explored in future researches.
5-hydroxytryptamine (5-HT) is an important brain intestinal peptide that affects gastrointestinal function in patients with diarrhea-type irritable bowel syndrome. In recent years, it has been found that any abnormality in any of the signal transduction processes such as synthesis, release, binding to receptors and reuptake of 5-HT may lead to the development of diarrhoeal irritable bowel syndrome. In order to explore the potential therapeutic value of serotonin in diarrhea type irritable bowel syndrome, but also to provide a theoretical reference and basis for Chinese medicine for the prevention and treatment of diarrhea type irritable bowel syndrome. Through reviewing a large number of domestic and foreign literatures, the author found that traditional Chinese medicine (TCM) had a significant effect in the treatment of diarrhea type irritable bowel syndrome by regulating 5-HT. Therefore, the author reviewed the modern medical understanding of 5-HT, the correlation between 5-HT and diarrhea-type irritable bowel syndrome, and the research progress of TCM intervention with 5-HT in the treatment of diarrhea-type irritable bowel syndrome, in order to explore the potential therapeutic value of 5-HT in diarrhea-type irritable bowel syndrome. Meanwhile, it also provides a theoretical reference and basis for TCM in the prevention and treatment of diarrhea-type irritable bowel syndrome.
At present, almost all the definitions of hypertension in pediatric hypertension guidelines issued by countries and organizations are based on blood pressure percentile of 95% (P95). However, a large number of research data have shown that high normal blood pressure has a higher risk of progression to hypertension and cause similar target organ damage as hypertension. The review summarized the classification methods of blood pressure of children and adolescents in different countries and organizations, the prevalence of hypertension and high normal blood pressure, the rate of progression from high normal blood pressure to hypertension, and target organ damage caused by high normal blood pressure in children and adolescents, emphasizing that pediatricians should pay greater attention to the definition of high normal blood pressure and hypertension for children and adolescents.
In recent years, due to the increase of life stress, there is an increasing number of the men and women of childbearing age suffering from hypertension in China. Therefore, the standardized management of hypertension during the preparation for pregnancy has become a current focus. The standardized management of blood pressure of males and females of childbearing age during pregnancy preparation was discussed in this paper in terms of both monitoring and evaluating of hypertension during the preparation for pregnancy and application of antihypertensive drugs, emphasizing that the management of hypertension during pregnancy preparation in women should consider both maternal and fetal safety, choose relatively safe antihypertensive drugs such as methyldopa, labetalol, nifedipine, etc; the management of hypertension during pregnancy preparation in men should consider the efficacy of antihypertensive drugs and the effects on sexual function and sperm, Nebivolol, ACEI/ARB and CCB drugs are recommended, in order to provide guidance for the management of hypertension during the preparation for pregnancy reference direction for future research.
Chronic and refractory wounds are serious complications of diabetes mellitus, and have no effective treatments. Numerous studies have confirmed that events such as inflammatory response, angiopoiesis and matrix remodeling are closely related to mitochondrial function during diabetic wound healing. Phosphatase and tensin homologue-induced kinase 1 (PINK1) is a serine/threonine protein kinase primarily located in mitochondria, which is involved in regulating mitochondrial autophagy to protect cells from oxidative stress, and plays an important role in regulating inflammatory responses and promoting lipid metabolism. Mutations in the PINK1 gene are closely related to the onset of Parkinson's syndrome. Recent studies also show that PINK1 may be involved in regulating the development of type 2 diabetes. We gave a description of the mechanism of action of PINK1 in regulating diabetic wound healing after reviewing the latest relevant research, and found that existing studies have failed to reveal the molecular mechanism and the time sequence and interaction of signal transduction process involved by PINK1 in different stages of wound healing. Moreover, there is still a lack of in vivo research on PINK1 regulating the healing of refractory diabetic wounds. It is hoped that further clinical research could provide more ideas for the treatment of refractory diabetic wounds.
